Organization
PORTER-STARKE SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY K. IDSTEIN CPA (EXECUTIVE VICE PRESIDENT, FINANCE)
(219) 531-3500
Entity
Organization
Contact information
Practice address
2507 CUMBERLAND DR, VALPARAISO, IN 46383-2503
(219) 476-4676
(219) 462-3975
Mailing address
601 WALL ST, VALPARAISO, IN 46383-2512
(219) 531-3500
(219) 462-3975
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
418-0-ASR
IN
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
418-0-CMHC
IN
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
418-0-GAM
IN
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
418-0-SMI
IN
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
418-14-9-14
IN
261QM2800X
Methadone Clinic
61100664B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000112682
ANTHEM
IN
05
—
100207670A
—
IN
01
—
CB7125
MEDICARE RAILROAD
IN
Enumeration date
05/19/2006
Last updated
06/16/2023
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